Employment and Support Allowance

Transcription

1 Employment and Support Allowance April 201

2 This factsheet tells you about employment and support allowance (ESA) and how future changes will affect the benefit. It also provides information about recent changes and how these will affect you if you are still getting incapacity benefit, severe disablement allowance, and/or income support paid on the grounds of incapacity. What is employment and support allowance? ESA is a benefit for people who are unable to work due to an illness or a disability. It replaced incapacity benefit and income support paid on the basis of incapacity for new claims made on or after 27 October You must be aged 1 or over and under pension age to claim ESA ESA is an integrated benefit consisting of two parts: contributory ESA is paid on the basis of your national insurance contributions; income-related ESA is means-tested - i.e. affected by income or savings. ESA is paid at two different rates: a lower rate during a 13 week assessment period; then at one of two higher rates depending on whether you are placed in the work-related activity group or the support group. If you qualify for income-related ESA you may also get additional money if you are severely disabled, a carer or have mortgage costs. If you are employed and off sick from work you may get statutory sick pay (SSP) from your employer for the first 28 weeks of illness. You cannot get ESA during this time but if you are still unable to work after 28 weeks, you can then claim ESA, even if your employer continues to pay contractual sick pay. If you do not qualify for SSP or if your employer stops paying SSP during the first 28 weeks of your illness, for example, because your contract of employment ends, you should claim ESA straight away. If you receive a private or occupational pension, your contributory ESA is reduced by half the pension payments above 85 a week. If you get income-related ESA, these pensions will count in full as income. Jobseeker s allowance (JSA) claimants can continue to get JSA, rather than claim ESA, if unable to work due to illness for up to 13 weeks. If this might apply to you, seek advice to see which benefit would be more appropriate in your circumstances. How do I qualify for contributory ESA? You will need to have paid sufficient national insurance contributions in specific tax years to get contributory ESA. The rules are relaxed for certain carers, disabled workers, and previous ESA claimants. Contributory ESA is only paid for one year if you are in the work-related activity group. The time limit does not apply to those in the support group. See appendix 2 for the criteria for being placed in the support group. If you think you satisfy any of these you can ask to be reassessed - see page

3 How do I qualify for income-related ESA? If you haven t worked, or have not paid enough national insurance contributions to get contributory ESA, or have been taken off contributory ESA after a year, you may be able to claim income-related ESA. It is also possible to get income-related ESA to top up contributory ESA, for example, if you have mortgage costs, or you are severely disabled or a carer. Income-related ESA is means-tested and you need to satisfy the income and capital rules - see page 8. Income-related ESA will be replaced by universal credit at some point over the next few years see page 12. If you are not sure about which type of ESA to claim it may be advisable to claim both contributory and income-related ESA. How do I claim ESA? You can claim ESA by phoning the jobcentre plus contact centre on or downloading an ESA 1 claim form from It is the same form for both contributory and incomerelated ESA. If you want to claim income-related ESA, either on its own or as a top-up to contributory ESA, make sure you tell the DWP officer if you are completing the form over the phone or tick the relevant box on the paper claim form. Most people need to submit a fit note from their GP (previously known as a medical certificate or sick note) at the start of the claim. You must continue to do this until you are assessed for limited capability for work. If you put your mobile number on the top right corner of the fit note you should receive a text to say it has been received by the DWP and also be informed when you can expect payment. However you need to wait 7 working days for it to be received and logged. You should also try and have the following information when you make your claim: national insurance number, medical certificate, GP s address and phone number, home and mobile telephone numbers, mortgage or landlord details, council tax bill, employer s address and telephone number, dates of employment or last day worked, bank account details, savings, details of any other money you have coming in eg benefits or sick pay. You cannot be paid ESA until seven days after you have made the claim. However, ESA can be backdated for up to three months prior to the date of the claim. You do not need special reasons. However you will need to provide a fit note from your GP to confirm that you were not fit for work during that period. What happens after I ve claimed? Once you claim ESA, you will usually enter a 13-week assessment phase and receive ESA at the basic rate. This applies to all new ESA claimants except those who are terminally ill

4 During the assessment phase you will undergo a work capability assessment (WCA) which tests you in the following areas: an assessment of limited capability for work this looks at the extent of your overall physical and mental disabilities. You must have limited capability for work to get ESA; an assessment of limited capability for work-related activity this looks at your ability to do some form of work-related activity. If you are considered to have limited capability for work-related activity you will be placed in the support group and won t have to engage in any work preparation. If, however, the decision maker considers you have some capacity for work you will be placed into the work-related activity group. What does the limited capability for work test involve? Around a month after you first claim, most claimants are sent an ESA 50 self-assessment questionnaire to complete. This is a test of your ability to perform certain activities and points are awarded based on your ability to carry them out. You normally have four weeks to return the form. If it is not returned by this deadline you will be treated as being capable of work and your benefit will stop, unless you can show that you have good cause for not returning the questionnaire. Most claimants are also required to attend a medical assessment. The form consists of a series of tick boxes about how any physical or mental conditions affect your ability to carry out various specific everyday activities. For each activity, there are a series of statements called descriptors describing the difficulties that you may have in that activity. You score points for each descriptor that applies to you and points scored in each activity are added together. If you get points or more you are considered to have limited capability for work and have passed the assessment. You can combine points from the physical and mental descriptors. If you do not get points you are considered not to have limited capability for work and do not qualify for ESA. However, you can still be treated as having limited capability for work if you are suffering from: an uncontrolled or uncontrollable life threatening disease or some physical or mental disease or disablement which would be a substantial risk to you or anyone else if you were found not to have limited capability for work; however you must also be able to show that this risk could not be significantly reduced by reasonable adjustments being made to the workplace or by taking prescribed medication If you fail the work capability assessment you can challenge the decision - see page 10. For further information see the guides to completing an ESA 50 and ESA appeals on

5 What happens at the medical assessment? After the form has been received by the DWP you are invited to a local assessment centre for a medical examination. These are usually held in Luton for Hertfordshire residents. You can reclaim your travelling expenses and those of a companion, if you need one. If you can t travel by public transport, you can claim for taxi fares with prior approval. You will need a doctor s letter confirming you are unable to use public transport. If you are not able to travel at all, you can ask for the assessment to be carried out in your home but, again, you will need a doctor s letter. In Hertfordshire assessments are carried out by the Centre for Health and Disability Assessments (operated by Maximus) on behalf of the DWP. You are normally given seven days notice of the date of the medical. If you are unable to go, you should inform the office that arranged the medical straight away. If you fail to attend, your benefit will be stopped unless you can show you have a good reason for not attending. The assessment is carried out using a computer-based questionnaire. You are likely to be asked questions about how you travelled to the assessment centre and how you intend to travel back. It is important to explain any difficulties you had with the journey. It is also important to tell the healthcare professional about your abilities to perform certain functions and the difficulties you have. If your condition or ability varies from day to day remember to say so. If you can only perform an activity with pain or it causes tiredness, either that day or in the following days, remember to mention this. It is the effect of your condition over time, not just on the day of your assessment that should be taken into account. You can ask for the medical assessment to be audio recorded. However, a request will only be considered if it is made in advance and this can cause delays. Is everyone subject to the limited capability for work test? You are treated as satisfying the test for ESA purposes if you are: terminally ill * undergoing, or recovering from, any form of chemotherapy or radiotherapy, or are likely to receive chemotherapy within months and the decision maker is satisfied that the cancer treatment has work-limiting side effects and these are likely to limit all forms of work someone who meets the eating and drinking descriptors in the limited capability for work related activities assessment (see appendix 2) excluded from work due to a notifiable disease in hospital (including residential drug or alcohol rehabilitation programmes) or recovering from treatment as an inpatient you are treated as an inpatient where a health professional has advised a stay of 24 hours or more pregnant and entitled to maternity allowance or you are in the period between weeks before the baby is due up to 2 weeks after the actual birth, and you are not entitled to

6 maternity allowance or statutory maternity pay for that period, or there is a serious risk to you or the unborn child if you do not refrain from work a student in full time education and eligible for income-related ESA because you receive DLA or PIP receiving one of the following treatments or recovering from such treatments and the DWP is satisfied you should be treated as having limited capability for work: haemodialysis for chronic renal failure plasmapheresis total parenteral nutrition for gross impairment of enteric function * If you are terminally ill you will move into the support group straight away without having to undergo the 13 week assessment period. You will need to ask your health care professional for a DS00 certificate. There will be some differences to these rules under universal credit see for updates. How is the decision made? Once enough information has been collected, this will be passed on to a DWP decision maker who will decide whether you qualify for ESA. If you do, they will also decide the level of benefit you should get. This is determined by another test called the limited capability for work-related activity assessment. You will be sent a decision letter, and if awarded, will enter the main phase of benefit and your payments will increase. What is the limited capability for work-related activity assessment? This assessment looks at whether or not you have limited capability for work-related activity. It determines whether you are placed in the support group or the work-related activity group and the level of extra benefit you get. The test has a list of descriptors relating to severe limitations of physical or mental health functions. If at least one of these applies you will be placed in the support group and not be required to undertake any workrelated activity. When will I be placed in the support group? You will be put in the support group after the 13 week assessment period if you are considered to have limited capability to do work-related activities because one of the descriptors in appendix 2 applies to you. Some people are treated as though they have passed this test. You are automatically placed in the support group if you: are terminally ill and do not need to go through 13 week assessment are receiving any form of chemotherapy or radiotherapy or are likely to receive chemotherapy or radiotherapy in the next months; the decision maker must be

7 satisfied that the cancer treatment has work limiting side effects and those are likely to limit all forms of work are pregnant and there is a serious risk to you or your unborn child if you don t refrain from work-related activity have some physical or mental disease or disablement which would be a substantial risk to you or anyone else if you were found not to have a limited capability for workrelated activity If you are placed in the support group you are not required to attend work-focused interviews or undertake any form of work preparation. When will I be placed in the work-related activity group? If you don t satisfy the conditions for the support group you will be placed in the workrelated activity group. You will have to comply with strict work-related conditions. You will have to attend regular work-focused interviews with a personal adviser and in some cases take part in the Work Programme. If you fail to comply with the work related requirements your benefit can be reduced through sanctions. What is a work-focused interview? Work-focused interviews are intended to assess and identify: your prospects of gaining work ways to encourage you back to work activities that may increase your chances of gaining work training, rehabilitation or educational opportunities that will increase your chances of finding work current or future work opportunities (including self-employment) that are relevant to you During these interviews an action plan will be drawn up. This will record the interview and any agreement made about carrying out work-related activity. It is possible to defer an interview, for example, if your condition has got worse or you go into hospital. When can benefit sanctions be applied? Sanctions will apply if you get ESA, have been placed in the work-related activity group and you fail, without good reason, to attend a work-focused interview, or meet requirements relating to work preparation. Your ESA will be reduced by the personal amount for a single claimant (currently per week). The period of reduction is one week for each 7 day period during which you fail to meet the condition and a further fixed period of 7,14 or 28 days. However, the initial week's reduction will not be applied if you meet the condition within one week of the failure date

8 A good reason for not attending a work-focused interview can include things like being too ill to attend, problems with literacy, language or transport, or any other good cause. You have to give these reasons within 5 days of being notified that you did not attend. If the work coach does not accept your reasons you have the right to ask for a mandatory reconsideration within a month of their decision followed by an appeal to an independent tribunal if you are still not satisfied see page 10. If you are affected by these sanctions you can apply for a hardship payment of incomerelated ESA if you have no other means of financial support. You can get 0% of the ESA personal allowance, which is paid in addition to any premiums or housing costs. Hardship payments of ESA are not recoverable. Ring Jobcentre Plus on How much ESA will I get? This will depend on whether you are claiming the contributory or income-related ESA or a combination of the two. Contributory ESA For the first 13 weeks you will receive the basic weekly allowance: single person aged under single person aged 25 or over After 13 weeks, everyone is paid the basic weekly rate for a person aged 25 or over, plus an additional component, depending on which group you have been placed in: work-related activity component 2.05 or support component 3.20 Income-related ESA If you are claiming income-related ESA you will be subject to a means test which looks at your income and your savings in the same way as income support. Your income is then topped up to a basic level of benefit. If you have savings of more than 1,000, you cannot get income-related ESA. If you have between,000 and 1,000 in savings, the amount of income-related ESA you get will be reduced by 1 a week for every 250 (or part of 250) you have over,000. Couples If you are part of a couple (including same sex couples) your partner s savings and income are also taken into account. If your partner works 24 hours or more, you cannot claim income-related ESA. Income-related ESA is paid at different rates depending upon your personal circumstances and is made up of different components: A basic allowance - paid for the first 13 weeks: single person aged under

9 single person aged 25 or over couple where both are 18 or over After 13 weeks you will receive an additional component of either the: work-related activity component 2.05 or support component 3.20 There are plans to remove the extra amount for those in the work-related activity group for new claims from April Premiums If you are claiming income-related ESA you may also qualify for additional weekly money in the form of the following premiums: carer premium - paid if you are a carer who receives, or has an underlying entitlement to, carer s allowance enhanced disability premium - paid if you or your partner receive the higher rate of the care component of disability living allowance (DLA), the enhanced rate of the daily living component of the personal independence payment (PIP) or the higher rate of attendance allowance (AA). You will also get the enhanced disability premium if you have been placed in the support group -.75 for a single claimant, 22.0 for a couple severe disability premium - paid if you get DLA care component at the middle or higher rate, or the daily living component of PIP, or attendance allowance/constant attendance allowance, and no one gets carer s allowance for looking after you, and you are treated as living alone single claimant or for a couple where both members of the couple meet the qualifying conditions or one is getting a qualifying benefit and the other is registered blind. Housing costs In some circumstance you may be able to claim help towards your mortgage interest payments on up to 200,000 of your loan or mortgage at a rate of 3.12% per annum and some other housing costs as part of your income-related ESA. There is a qualifying period of 3 weeks for most new claimants. For more information please see help to pay mortgage costs on Can I work and claim ESA? If you start working full-time, your ESA will stop. However the law allows you to claim ESA and do some types of exempt work such as being a councillor doing domestic tasks in your home caring for a close relative volunteering working while receiving assistance as a self-employed person from the Government s test trading scheme

10 You can also take up certain work and still get full ESA. This is called permitted work. Permitted work Permitted work allows you to do some paid work and still get your full ESA (and housing/council tax benefit). Even though it won t affect your benefit you should tell the DWP as soon as possible if you do any work. There are different types of permitted work: work done as part of a hospital treatment programme carried out under medical supervision for earnings which do not exceed 1.50 a week for an unlimited period; permitted work lower limit - this is any work undertaken for no more than 20 a week for an unlimited period; supported permitted work for earnings which do not exceed 1.50 a week for an indefinite period - supported work means work that is supervised by someone employed by a public or local authority or voluntary organisation whose job it is to arrange work for people with disabilities e.g. Hertfordshire County Council s Work Solutions; permitted work higher limit - this is work of less than 1 hours a week, with earnings which do not exceed 1.50 per week. At present this can only be done for a maximum of 52 weeks, unless you are in the support group; however, from April 2017 the time limit will be removed for claimants in the work-related activity group too. Earnings from permitted work described above will not affect either type of ESA and are also disregarded for housing and council tax benefit. Will I be worse off if I come off ESA to try work? If you are thinking of returning to work you may be entitled to additional benefits such as working tax credit (up until the introduction of universal credit). For more information on these and other benefits that you may be able to claim, see work and benefits on What can I do if I am unhappy with a decision? If you are unhappy with any decision about ESA, for example, if you have failed the limited capability for work assessment, you have failed to attend a medical, or if you think you should have been placed in the support group, you can challenge the decision. You must ask the DWP for a mandatory reconsideration first. You must usually do this within one month from the date of the decision but it may be possible to ask for a late reconsideration (within 13 months) in special circumstances. Your ESA will not be reinstated during this stage and to continue to get money you will have to claim another benefit, for example, JSA or income support

11 If you are unhappy with the new decision, you can then appeal to an independent tribunal. You should complete form SSCS1 and send it direct to HM Courts and Tribunals Service. You must also enclose a copy of the mandatory reconsideration notice. In this situation you are entitled to receive ESA at the assessment rate until the appeal hearing unless you are challenging a fit to work decision on a repeat claim. If you have successfully claimed another benefit, such as JSA, during the mandatory reconsideration period, this will remain in payment pending the appeal hearing, unless you ask for the ESA to be reinstated. For further advice see our ESA appeals guide on If you are still waiting for an appeal hearing against a decision made before 28 October 2013 you should seek advice as the rules were slightly different. What happens if I make another claim for ESA? If you make a repeat claim for ESA after being found not to have limited capability for work you will not be awarded ESA pending a fresh work capability assessment unless you can demonstrate that there has been a significant worsening in your condition or that a new health condition has developed. This rule does not apply where a repeat claim is made more than six months after a previous decision that you were treated as having limited capability for work because you failed to return the ESA50 or attend the medical examination. In these circumstances you can get ESA at the assessment rate while you are waiting for a new assessment. If you cannot get ESA you may need to consider claiming jobseeker s allowance or income support if you qualify as a carer or as a lone parent. What if I am still getting incapacity benefit, severe disablement allowance or income support on the basis of incapacity? If you are still getting any of the above benefits you will be reassessed for employment and support allowance. This is known as the conversion process and you will be subject to the work capability assessment, which will decide whether your claim is converted to ESA. Jobcentre plus should write and let you know when this is going to happen. In most cases you will be sent an ESA50 questionnaire to complete - see above for more details. It is very important that you fill this in and send it back. If the form is not returned within the time limit - your benefit will be stopped. Once the form is received most people will then be invited to attend a medical assessment. If you pass this, you will go straight into the main phase of ESA and be placed in either the work related activity group or the support group. If your claim is converted to ESA but your entitlement to ESA is less than your previous benefit you will receive a top up so your benefit will not be reduced. If your ESA is higher

12 your benefit will be increased. However, you should seek independent advice to check that the amount you are getting is correct as some people have missed out on meanstested additions when they have been converted over and it may be possible to get these backdated. If you don t pass the work capability assessment, your benefit will stop. You can challenge this decision. See page 10 for more information. Is ESA affected by the benefit cap? Total benefit payments to working age households are now subject to a benefit cap of 350 for single people/ 500 for couples and those with children. Both contributory and income-related ESA count towards this cap. However, certain people are exempt from the benefit cap including those who are in the ESA support group or receiving disability living allowance or the personal independence payment. The benefit cap is due to be reduced from autumn 201 to 20,000 a year for couples and lone parents and 13,400 for singles outside of London. Exemptions will be extended to those getting carer s allowance, guardian s allowance and the carer element in universal credit at the same time. See our benefit cap information on How will universal credit affect ESA? Income-related ESA is one of the benefits that are going to be replaced by universal credit. The new benefit is now available in Hertfordshire but only for new claims for certain single, childless work-seekers. Current planning is that universal credit will be rolled out to families, carers and those who have limited capability for work by late So, for the time being, you should still claim income-related ESA if you are unable to work and need means-tested support. Contributory ESA will remain a separate benefit but eventually you may need to top this up with universal credit. People getting income-related ESA will be migrated over to universal credit at some point after its full introduction. The system of disability premiums has been abolished in universal credit and you can only get an extra amount of money for your ill health if you are assessed as having limited capability for work (equivalent to ESA WRAG) or limited capability for work related activity (equivalent to ESA support group). If you would be worse off when you transfer, you will be given an extra amount to make up the shortfall, as long as you are part of the planned managed migration process. However, this transitional protection will end in the following circumstances: you have a partner who comes to live with you your partner leaves you you have a three-month earnings drop beneath the level of work that is expected according to your claimant commitment (see above)

13 you stop work your universal credit ends If you come on to universal credit as a result of a change of circumstance meaning you need to apply for universal credit instead, for example, you move in with someone who is already getting the new benefit, you will not be protected. There are no permitted work rules in universal credit. Instead you will be encouraged to do some work, if you are able to, and should be able to keep your limited capability for work element, at least until you are reassessed again. Universal credit includes amounts for housing costs and children. For more information on this and other changes that will affect you once you claim universal credit, see our factsheet on Further help and advice Citizens Advice Bureaux (CAB) Online information: Information about local CABx and opening times: How you can contact Hertfordshire County Council Our website Visit our website for more information about support for carers and adult social care - make a referral for care services or apply online for meals on wheels or a Blue Badge If you would like more information about benefits and debt you can find a wide range of factsheets Hertfordshire Directory Find national and local community groups, charities, services and activities HertsHelp Independent information and advice on local community services and care funding Telephone: Minicom: info@hertshelp.net Call us For information and advice on how to get care and support Telephone: Text Message: Textphone: Calls to 0300 cost no more than a national rate call to a 01 or 02 number If you are worried that you or someone you know is at risk of abuse or neglect

14 Call us on (24 hours a day) If you need help to understand Call if you would like help to understand this information or need it in a different format. You can also ask to speak to someone in your own language

15 Appendix 1 ASSESSMENT OF WHETHER A CLAIMANT HAS LIMITED CAPABILITY FOR WORK Part 1 Physical disabilities Activity Descriptors Pts 1. Mobilising unaided by Cannot either: another person with or without a walking stick, manual wheelchair or other aid if such aid is normally, or could reasonably be, worn or used. (i) mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion; or (ii) repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion. Cannot mount or descend two steps unaided by another person even with the support of a handrail. Cannot either: (i) mobilise more than 100 metres on level ground without stopping in order to avoid significant discomfort or exhaustion; or (ii) repeatedly mobilise 100 metres within a reasonable timescale because of significant discomfort or exhaustion. (d) Cannot either: (i) mobilise more than 200 metres on level ground without stopping in order to avoid significant discomfort or exhaustion; or (ii) repeatedly mobilise 200 metres within a reasonable timescale because of significant discomfort or exhaustion. (e) None of the above apply

16 Activity Descriptors Pts 2. Standing and sitting. Cannot move between one seated position and another seated position located next to one another without receiving physical assistance from another person. Cannot, for the majority of the time, remain at a work station, either: (i) standing unassisted by another person (even if free to move around); or (ii) sitting (even in an adjustable chair); or (iii) a combination of (i) and (ii) for more than 30 minutes, before needing to move away in order to avoid significant discomfort or exhaustion. Cannot, for the majority of the time, remain at a work station, either: (i) standing unassisted by another person (even if free to move around); or (ii) sitting (even in an adjustable chair) or (iii) a combination of (i) and (ii) for more than an hour before needing to move away in order to avoid significant discomfort or exhaustion. (d) None of the above apply 0 3. Reaching. Cannot raise either arm as if to put something in the top pocket of a coat or jacket. Cannot raise either arm to top of head as if to put on a hat. Cannot raise either arm above head height as if to reach for something. (d) None of the above apply

17 Activity Descriptors Pts 4. Picking up and moving or transferring by the use of the upper body and arms. Cannot pick up and move a 0.5 litre carton full of liquid. Cannot pick up and move a one litre carton full of liquid. Cannot transfer a light but bulky object such as an empty cardboard box. (d) None of the above apply Manual dexterity. Cannot either: (i) press a button, such as a telephone keypad; or (ii) turn the pages of a book with either hand. (d) Cannot pick up a 1 coin or equivalent with either hand. Cannot use a pen or pencil to make a meaningful mark. Cannot single handedly use a suitable keyboard or mouse. (e) None of the above apply. 0. Making self understood through speaking, writing, typing, or other means which are Cannot convey a simple message, such as the presence of a hazard. normally, or could reasonably be, used, unaided by another person. Has significant difficulty conveying a simple message to strangers Has some difficulty conveying a simple message to strangers. (d) None of the above apply

18 Activity Descriptors Pts 7. Understanding communication Cannot understand a simple message by (i)verbal means (such as due to sensory impairment, such as the hearing or lip reading) alone, location of a fire escape. (ii) non-verbal means (such as reading 1 point print or Braille) alone, or Has significant difficulty understanding (iii) a combination of (i) and (ii), a simple message from a stranger due using any aid that is normally, or to sensory impairment. could reasonably be, used unaided by another person. Has some difficulty understanding a simple message from a stranger due to sensory impairment. (d) None of the above apply Navigation and maintaining Unable to navigate around familiar safety, using a guide dog or surroundings, without being other aid if either or both are accompanied by another person, due normally, or could reasonably to sensory impairment. be, used. Cannot safely complete a potentially hazardous task such as crossing the road, without being accompanied by another person, due to sensory impairment. Unable to navigate around unfamiliar surroundings, without being accompanied by another person, due to sensory impairment. (d) None of the above apply. 0. Absence or loss of control At least once a month experiences: whilst conscious leading to extensive evacuation of the bowel and/or bladder, other than enuresis (bed-wetting), despite the wearing or use of any aids or (i) loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder; or (ii) substantial leakage of the contents of a collecting device sufficient to require cleaning and a change in

19 Activity Descriptors Pts adaptations which are normally, clothing. or could reasonably be, worn or used. The majority of the time is at risk of loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder, sufficient to require cleaning and a change in clothing, if not able to reach a toilet quickly. None of the above apply Consciousness during At least once a week, has an waking moments. involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration. At least once a month, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration. None of the above apply

20 PART 2 Mental, cognitive and intellectual function assessment 11. Learning tasks. Cannot learn how to complete a simple task, such as setting an alarm clock. Cannot learn anything beyond a simple task, such as setting an alarm clock. Cannot learn anything beyond a moderately complex task, such as the steps involved in operating a washing machine to clean clothes. (d) None of the above apply Awareness of everyday hazards Reduced awareness of everyday hazards (such as boiling water or sharp leads to a significant risk of: objects). (i) injury to self or others; or (ii) damage to property or possessions such that they require supervision for the majority of the time to maintain safety. Reduced awareness of everyday hazards leads to a significant risk of (i) injury to self or others; or (ii) damage to property or possessions such that they frequently require supervision to maintain safety. Reduced awareness of everyday hazards leads to a significant risk of: (i) injury to self or others; or (ii) damage to property or possessions such that they occasionally require supervision to maintain safety. (d) None of the above apply

21 13. Initiating and completing Cannot, due to impaired mental function, personal action (which means reliably initiate or complete at least 2 planning, organisation, problem sequential personal actions. solving, prioritising or switching tasks). Cannot, due to impaired mental function, reliably initiate or complete at least 2 personal actions for the majority of the time. Frequently cannot, due to impaired mental function, reliably initiate or complete at least 2 personal actions. (d) None of the above apply Coping with change. Cannot cope with any change to the extent that day to day life cannot be managed. Cannot cope with minor planned change (such as a pre-arranged change to the routine time scheduled for a lunch break), to the extent that overall day to day life is made significantly more difficult. Cannot cope with minor unplanned change (such as the timing of an appointment on the day it is due to occur), to the extent that overall, day to day life is made significantly more difficult. (d) None of the above apply. 0. Getting about. Cannot get to any place outside the claimant s home with which the claimant is familiar. Is unable to get to a specified place with which the claimant is familiar, without being accompanied by another person. Is unable to get to a specified place with

22 which the claimant is unfamiliar without being accompanied by another person. (d) None of the above apply Coping with social engagement Engagement in social contact is always due to cognitive impairment or precluded due to difficulty relating to others mental disorder. or significant distress experienced by the individual. Engagement in social contact with someone unfamiliar to the claimant is always precluded due to difficulty relating to others or significant distress experienced by the individual. Engagement in social contact with someone unfamiliar to the claimant is not possible for the majority of the time due to difficulty relating to others or significant distress experienced by the individual. (d) None of the above apply Appropriateness of behaviour Has, on a daily basis, uncontrollable with other people, due to cognitive episodes of aggressive or disinhibited impairment or mental disorder. behaviour that would be unreasonable in any workplace. Frequently has uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace. Occasionally has uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace. (d) None of the above apply

23 Appendix 2 ASSESSMENT OF WHETHER A CLAIMANT HAS LIMITED CAPABILITY FOR WORK RELATED ACTIVITY Activity Descriptors 1. Mobilising unaided by another person with or without Cannot either: a walking stick, manual wheelchair or other aid if such aid is normally, or could reasonably, be worn or used mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion; or repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion. 2. Transferring from one seated position to another. Cannot move between one seated position and another seated position located next to one another without receiving physical assistance from another person. 3. Reaching. Cannot raise either arm as if to put something in the top pocket of a coat or jacket. 4. Picking up and moving or transferring by the use of the upper body and arms (excluding standing, sitting, bending or kneeling and all other activities specified in this Schedule). 5. Manual dexterity. Cannot pick up and move a 0.5 litre carton full of liquid. Cannot either: press a button, such as a telephone keypad; or turn the pages of a book with either hand.. Making self understood through speaking, writing, typing, or other means which are normally, or could reasonably be, used, unaided by another person. Cannot convey a simple message, such as the presence of a hazard

24 Activity Descriptors 7. Understanding communication by (i) verbal means (such as hearing and lip reading) alone, Cannot understand a simple or message due to sensory impairment, (ii) non-verbal means (such as reading 1 point print or such as the location of a fire escape. Braille) alone or (iii) a combination of (i) and (ii) using any aid that is normally, or could reasonably, be used unaided by another person 8. Absence or loss of control whilst conscious leading to extensive evacuation of the bowel and/or voiding of the bladder, other than enuresis (bed-wetting), despite the wearing or use of any aids or adaptations which are normally, or could reasonably be, worn or used. At least once a week experiences: loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder; or substantial leakage of the contents of a collecting device sufficient to require the individual to clean themselves and change clothing.. Learning tasks. Cannot learn how to complete a simple task, such as setting an alarm clock, due to cognitive impairment or mental disorder. 10. Awareness of hazard. Reduced awareness of everyday hazards, due to cognitive impairment or mental disorder, leads to a significant risk of: injury to self or others; or damage to property or possessions 11. Initiating and completing personal action (which means planning, organisation, problem solving, prioritising or switching tasks). such that they require supervision for the majority of the time to maintain safety. Cannot, due to impaired mental function, reliably initiate or complete at least 2 sequential personal actions

25 Activity Descriptors 12. Coping with change. Cannot cope with any change, due to cognitive impairment or mental disorder, to the extent that day to day life cannot be managed. 13. Coping with social engagement, due to cognitive impairment or mental disorder. Engagement in social contact is always precluded due to difficulty relating to others or significant distress experienced by the individual. 14. Appropriateness of behaviour with other people, due to cognitive impairment or mental disorder. Has, on a daily basis, uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace.. Conveying food or drink to the mouth. Cannot convey food or drink to the claimant s own mouth without receiving physical assistance from someone else; Cannot convey food or drink to the claimant s own mouth without repeatedly stopping, experiencing breathlessness or severe discomfort; Cannot convey food or drink to the claimant s own mouth without receiving regular prompting given by someone else in the claimant s physical presence; or (d) Owing to a severe disorder of mood or behaviour, fails to convey food or drink to the claimant s own mouth without receiving: (i) physical assistance from someone else; or (ii) regular prompting given by someone else in the claimant s presence

26 Activity Descriptors 1. Chewing or swallowing food or drink. Cannot chew or swallow food or drink; Cannot chew or swallow food or drink without repeatedly stopping, experiencing breathlessness or severe discomfort; Cannot chew or swallow food or drink without repeatedly receiving regular prompting given by someone else in the claimant s presence; or (d) Owing to a severe disorder of mood or behaviour, fails to: (i)chew or swallow food or drink; or (ii)chew or swallow food or drink without regular prompting given by someone else in the claimant s presence. This information is correct at time of print. It is for guidance only and is not an authoritative statement of the law